Analysis of Planning Risk Volume for Heart during Radiotherapy Delivery with Breath-Hold Technique for Carcinoma of Left Breast.

IF 0.7 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Medical Physics Pub Date : 2024-10-01 Epub Date: 2024-12-18 DOI:10.4103/jmp.jmp_45_24
Radhika Jain, Rose Kamal, Manoj K Semwal, Deepak Thaper, Shefali Kanwar, Tripti Saxena
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Abstract

Purpose: The purpose of the study was to analyze and estimate planning risk volume (PRV) margin for heart in deep inspiration breath hold (DIBH)-based left breast radiotherapy.

Materials and methods: Fifty left-sided cancer breast cases treated with volumetric modulated arc radiotherapy were included in this retrospective study. Treatment plans were created using the Eclipse treatment planning system from Varian Medical System. The treatment was delivered on TrueBeam linear accelerator (Varian). Onboard cone-beam computed tomography (CBCT) images were generated and image registration between the planning computed tomography images and the CBCT images was performed before treatment delivery. The registration provided the shifts (errors) values in 6° of freedom, namely three translational and three rotational. From the shift values, the systematic and random errors were estimated which were used to estimate PRV margin for the heart after incorporating the rotational errors with the translational errors.

Results: The systematic error values after incorporating rotational errors with translational errors were 0.13 cm (lateral) and 0.11 cm (cranio caudal [CC] and anterioposterior each), and the random error values were 0.16 cm (lateral) and 0.13 cm (CC and anterioposterior each). Based on these values, the PRV margins for the heart in all three directions were 0.24 cm (lateral), 0.20 cm (CC), and 0.19 cm (anterioposterior).

Conclusion: As per our institutional practice, the 2 mm value for PRV margin for the heart in all the three directions would suffice for appropriate sparing of the heart during DIBH-based radiation therapy.

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屏气技术治疗左乳癌放疗过程中心脏规划风险量分析。
目的:分析和估计心脏在深度吸气屏气(DIBH)为基础的左乳放疗的计划风险容积(PRV)裕度。材料与方法:回顾性研究50例左侧癌性乳腺癌患者行体积调制弧线放疗。使用Varian医疗系统的Eclipse治疗计划系统创建治疗计划。采用TrueBeam直线加速器(Varian)进行治疗。生成机载锥形束计算机断层扫描(CBCT)图像,并在治疗交付前进行计划计算机断层扫描图像与CBCT图像之间的图像配准。配准提供了6°自由度的位移(误差)值,即三个平移和三个旋转。从位移值中估计出系统误差和随机误差,并结合旋转误差和平移误差来估计心脏的PRV裕度。结果:将旋转误差与平移误差合并后的系统误差值分别为0.13 cm(侧位)和0.11 cm(颅尾[CC]和前后位各),随机误差值分别为0.16 cm(侧位)和0.13 cm (CC和前后位各)。基于这些值,三个方向的心脏PRV边缘分别为0.24 cm(侧)、0.20 cm(前)和0.19 cm(正)。结论:根据我们的机构实践,在dibh放射治疗中,三个方向的心脏PRV切缘2mm值足以适当保留心脏。
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来源期刊
Journal of Medical Physics
Journal of Medical Physics RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.10
自引率
11.10%
发文量
55
审稿时长
30 weeks
期刊介绍: JOURNAL OF MEDICAL PHYSICS is the official journal of Association of Medical Physicists of India (AMPI). The association has been bringing out a quarterly publication since 1976. Till the end of 1993, it was known as Medical Physics Bulletin, which then became Journal of Medical Physics. The main objective of the Journal is to serve as a vehicle of communication to highlight all aspects of the practice of medical radiation physics. The areas covered include all aspects of the application of radiation physics to biological sciences, radiotherapy, radiodiagnosis, nuclear medicine, dosimetry and radiation protection. Papers / manuscripts dealing with the aspects of physics related to cancer therapy / radiobiology also fall within the scope of the journal.
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